The pancreas is an organ in the upper abdomen that has several functions. These include the production and release of digestive enzymes, as well as the production of hormones that help regulate blood sugar (sugar) levels.
Diabetes is a medical condition characterized by higher than normal blood sugar levels (hyperglycemia). It is associated with the pancreas due to the blood sugar regulating hormones produced there.
When the pancreas is damaged or inflamed, such as in pancreatitis, its ability to perform its essential functions is inhibited, often leading to other health problems, including diabetes. In addition, people with diabetes have a higher risk of developing pancreatitis.
What is pancreatitis?
Pancreatitis is inflammation of the pancreas. It can be acute, lasting only a few days, or chronic, lasting years. The main symptom of pancreatitis is upper abdominal pain that may spread to the back. However, the pain may be felt differently depending on whether you have acute or chronic pancreatitis.
Symptoms of acute pancreatitis may come on slowly or suddenly and range in severity from mild to severe. Other symptoms include fever, nausea, vomiting, fast heartbeat, and abdominal swelling or tenderness. People with acute pancreatitis often need to see a healthcare provider urgently because they often feel very sick.
People with chronic pancreatitis may experience upper abdominal pain that spreads to the back, or they may feel no pain at all. The pain can become more severe and persistent over time or after eating. However, the pain may also subside as the condition worsens. Other symptoms include diarrhea; nausea; vomiting; stools, foul-smelling stools; and weight loss.
The pancreas releases the hormones insulin and glucagon to help your body process glucose. Over time, chronic inflammation can damage the pancreas and its cells, including those that produce insulin and glucagon. When these cells are damaged, they cannot properly regulate blood sugar levels, increasing the risk of diabetes.
What are insulin and glucagon?
Insulin and glucagon are hormones made and released by the pancreas. Their main function is to regulate blood sugar (sugar) levels.
Insulin lowers blood sugar levels by acting as a key to opening cells, allowing glucose to leave the blood and enter cells for use as energy.
Instead, glucagon is sent to the liver to facilitate the breakdown of glycogen into glucose (called glycogenolysis). This helps raise blood sugar levels when blood sugar is too low (hypoglycemia).
The link between pancreatitis and diabetes
Pancreatic diabetes is a form of secondary diabetes that the American Diabetes Association (ADA) refers to as type 3c diabetes, or pancreoprivic diabetes. Both insulin and glucagon production and secretion are reduced in pancreatogenic diabetes. In addition, there is often a higher than expected insulin requirement.
Many cases of pancreatic diabetes are caused by chronic pancreatitis. Damage to the pancreas from inflammation disrupts its complex functions, including the digestion, absorption and utilization of nutrients. This results in a lack of insulin and glucagon production, as well as other hormones necessary for digestion.
Decreased insulin secretion eventually leads to the development of pancreatic-derived diabetes. Decreased glucagon secretion and consequent impaired glucose in the liver can also lead to glycemic fluctuations, accompanied by a hypoglycemic response.
common risk factors
If you have diabetes, you are more likely to get pancreatitis. An observational study of Japanese patients with type 2 diabetes found a significantly increased risk of acute pancreatitis compared with nondiabetic patients. Risk increases with age, and men are also at higher risk than women.
Similarly, a population-based cohort study in Taiwan found that people with type 2 diabetes had a nearly two-fold increased risk of acute pancreatitis compared with people without diabetes.
Another study investigated the pathophysiology behind the increased risk of acute pancreatitis in diabetes. The researchers hypothesized that insulin resistance and high blood sugar levels, two hallmarks of type 2 diabetes, are important factors associated with a higher risk of acute pancreatitis in diabetic patients.
Other possible causes of pancreatitis include gallstones, high triglyceride levels, obesity, smoking, and heavy alcohol consumption.
Studies have shown that certain diabetes medications may increase the risk of pancreatitis. However, some studies have provided mixed results. Overall, drug-induced acute pancreatitis is rare, occurring in approximately 0.5% of patients.
Still, it’s important to understand the potential side effects of a drug before taking it. Different types of diabetes medications associated with a higher risk of pancreatitis include glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors.
A 2011 review of the FDA’s database of reported adverse events found that patients taking exenatide, a GLP-1 receptor agonist, reported six fewer pancreatitis compared with other therapies. times more.
A 6-fold increase in reported cases of pancreatitis was also found in patients taking another diabetes drug called sitagliptin, a DPP-4 inhibitor.
However, a 2017 meta-analysis of randomized controlled trials found that the use of GLP-1 receptor agonists is safe and does not significantly increase the risk of pancreatitis.
With mixed results found in these and other studies, more research is needed to test the claim that some medications used to treat diabetes increase the risk of pancreatitis.
If you have diabetes, there are several things you can do to help reduce your risk of pancreatitis. These include keeping your blood sugar levels in a healthy range, controlling your triglyceride levels, maintaining a healthy weight, drinking alcohol only in moderation or not, and not smoking.
To help reduce your risk of diabetes when you have pancreatitis, make sure you check in with your healthcare provider regularly. Eating a healthy, balanced diet and getting regular physical activity can also go a long way in preventing disease.
When to see a healthcare provider or get emergency help
Call your healthcare provider or get emergency help right away if you experience any of the following:
- severe, persistent abdominal pain
- shaking, dizziness, or lightheadedness
- nausea or vomiting
- fatigue and lethargy
- breathing problems
- very fast heartbeat
- Unintentional weight loss
- yellowing of the skin and/or whites of the eyes (jaundice)
- greasy, foul-smelling stool
- any new or worsening pancreatitis symptoms
Just because you’ve been diagnosed with diabetes doesn’t mean you’ll go on to develop pancreatitis. Many people with diabetes can successfully manage their condition without any additional health complications. Likewise, having pancreatitis doesn’t mean you’ll have diabetes.
Your pancreas plays an important role in the regulation of blood sugar in your body. Therefore, you may want to discuss the link between pancreatitis and diabetes with your healthcare professional. They can explain the link between the two conditions and help you develop a personalized treatment plan for optimal care and risk reduction.